Schover Leslie R, Jenkins Rosell, Sui Dawen, Adams Jennifer Harned, Marion Michelle S, Jackson Karen Eubanks
University of Texas M.D. Anderson Cancer Center and Sisters Network Inc, National Headquarters, Houston, TX 77230-1439, USA.
J Clin Oncol. 2006 Apr 1;24(10):1620-6. doi: 10.1200/JCO.2005.04.7159.
We designed a peer counseling program to improve sexual function, increase knowledge about reproductive health, and decrease menopausal symptoms and infertility-related distress for African American breast cancer survivors.
Women were randomly assigned to immediate counseling or a 3-month waitlist. Three peer counselors conducted a 3-session intervention using a detailed workbook. Questionnaires at baseline, after the waitlist period, at posttreatment, and at 3-month follow-up assessed spirituality, sexual function, menopause symptoms, emotional distress, relationship satisfaction, fertility concerns, and knowledge about reproductive health and breast cancer. At the postcounseling assessment, women rated the workbook, their counselor, and the program.
Of 93 women screened, 60 women (65%) enrolled in the study. Women who completed counseling (80%; N = 48) had a mean age of 49 years (standard deviation [SD], 8 years) and a mean follow-up of 4.5 years (SD, 3.8 years) since cancer diagnosis. Almost all rated the workbook as very easy to understand (94%) and their counselor as very knowledgeable (96%) and very skillful (98%). Eighty-one percent rated the program as "very useful to me." Immediate counseling and waitlist groups did not differ at baseline in psychologic adjustment, nor did scores change during the waitlist period. Therefore, the groups were combined in analyzing outcomes. Knowledge of reproductive issues improved significantly from baseline to 3-month follow-up (P < .0001), as did emotional distress (P = .0047) and menopause symptoms (P = .0128). Sexually dysfunctional women became less distressed (P = .0167).
Women valued the Sisters Peer Intervention in Reproductive Issues After Treatment program highly and found it relevant. The program had positive effects on knowledge and target symptoms.
我们设计了一个同伴咨询项目，以改善性功能、增加生殖健康知识，并减轻非裔美国乳腺癌幸存者的更年期症状和不孕相关困扰。
女性被随机分配到立即咨询组或3个月的等待名单组。三名同伴咨询师使用一本详细的工作手册进行了为期三阶段的干预。在基线、等待期结束后、治疗后以及3个月随访时进行问卷调查，评估精神状态、性功能、更年期症状、情绪困扰、关系满意度、生育问题担忧以及生殖健康和乳腺癌知识。在咨询后评估中，女性对工作手册、她们的咨询师和项目进行评分。
在93名接受筛查的女性中，60名女性（65%）参与了研究。完成咨询的女性（80%；N = 48）自癌症诊断以来的平均年龄为49岁（标准差[SD]，8岁），平均随访时间为4.5年（SD，3.8年）。几乎所有女性都认为工作手册非常容易理解（94%），她们的咨询师知识非常渊博（96%）且技能非常娴熟（98%）。81%的女性将该项目评为“对我非常有用”。立即咨询组和等待名单组在基线时心理调适方面没有差异，在等待期内分数也没有变化。因此，在分析结果时将两组合并。从基线到3个月随访，生殖问题知识显著改善（P <.0001），情绪困扰（P =.0047）和更年期症状（P =.0128）也有所改善。性功能障碍的女性苦恼减轻（P =.0167）。
女性对“治疗后生殖问题姐妹同伴干预”项目评价很高，并认为它很有意义。该项目对知识和目标症状有积极影响。
